Abstract
The ribs are frequent sites of primary Ewing tumor accounting for about 10–12% of all cases. The lesions may be predominantly lytic or sclerotic or show a combination of bone destruction and secondary reactive changes. In some patients bony changes are subtle and are obscured initially by frequently associated large extrapleural masses or pleural fluid. These patients may present clinically with findings secondary to compression of mediastinal structures by the soft tissue masses. Computed tomography (CT) is of great value in the diagnosis of such difficult cases and better demonstrates the tumor extent and relationships than other available imaging modalities. CT is also of considerable help in determining the optimal time for en bloc tumor resection. Many tumors are initially considered non-resectable due to extensive involvement of the lung, the mediastinum, or the diaphragm. CT accurately documents tumor regression during preoperative courses of chemotherapy.
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Bhansali SK, Desai PB (1963) Ewing's sarcoma. Observations on 107 cases. J Bone Joint Surg [Am] 45:541
Branson J (1976) Ewing's tumor of a rib. Australas Radiol 20:341
Dahlin DC, Coventry MB, Scanlon PW (1961) Ewing's sarcoma. A critical analysis of 165 cases. J Bone Joint Surg [Am] 43:185
de Santos LA, Goldstein HM, Murray JA, Wallace S (1978) Computed tomography in the evaluation of musculoskeletal neoplasms Radiology 128:89
Dvorak PF, Vorlicky LN, Nesbit ME (1971) Ewing's sarcoma of the rib, presenting as the superior mediastinal syndrome. Clin Rediatr (Phila) 10:607
Edeiken J (1981) Roentgen diagnosis of diseases of bone, 3rd edn. Williams and Wilkins, Baltimore, p 273
Falk, S, Alpert M (1965) The clinical and roentgen aspects of Ewing's sarcoma. Am J Med Sci 250:492
Franken EA, Smith JA, Smith WL (1977) Tumors of the chest wall in infants and children. Pediatr Radiol 6:13
Freeman AI, Sachatello C, Gaeta J, Shah NK, Wang JJ, Sinks LF (1972) An analysis of Ewing's tumor in children at Roswell Park Memorial Institute. Cancer 29:1563
Ginaldi S, de Santos LA (1980) Computed tomography in the evaluation of small round cell tumors of bone. Radiology 134:441
Goldstein H, McNeil BJ, Zufall E, Treves S (1980) Is there still a place for bone scanning in Ewing's sarcoma? Concise communication. J Nucl Med 21:10
Gouliamos AD, Carter BL, Emami B (1980) Computed tomography of the chest wall. Radiology 134:433
Johnson RE, Pomeroy TC (1975) Evaluation of therapeutic results in Ewing's sarcoma. AJR 123:583
Joseph WL, Fonkalsrud EW (1972) Primary rib tumors in children. Am Surg 38:338
Levine E (1981) Computed tomography of musculoskeletal tumors. CRC Crit Rev Diagn Imaging 16:279
Levine E, Lee KR, Neff JR, Maklad NF, Robinson RG, Preston DF (1979) Comparison of computed tomography and other imaging modalities in the evaluation of musculoskeletal tumors. Radiology 131:431
Malangoni MA, Ofstein LC, Grosfeld JL, Weber TR, Eigen H, Baehner RL (1980) Survival and pulmonary function following chest wall resection and reconstruction in children. J Pediatr Surg 15:906
Murray RO, Jacobson HG (1977) The radiology of skeletal disorders, 2nd edn. Churchill Livingstone, New York, p 619
Pomeroy TC, Johnson RE (1975) Prognostic factors for survival in Ewing's sarcoma. AJR 123:598
Rosen G, Wollner N, Tan C, Wu SJ, Hajdu SI, Cham W, D'Angio GJ, Murphy ML (1974) Disease-free survival in children with Ewing's sarcoma treated with radiation therapy and adjuvant four-drug sequential chemotherapy. Cancer 33:384
Rosen G, Caparros B, Mosende C, McCormick B, Huvos AG, Marcove RC (1978) Curability of Ewing's sarcoma and considerations for future therapeutic trials. Cancer 41:888
Schmidt FE, Trummer MJ (1972) Primary tumors of ribs. Ann Thorac Surg 13:251
Sherman RS, Soong KY (1956) Ewing's sarcoma: Its roentgen classification and diagnosis. Radiology 66:529
Teitelbaum SL (1969) Tumors of the chest wall. Surg Gynecol Obstet 129:1059
Vogt-Moykopf I, Krumhaar D (1967) Management of primary rib tumors. Surg Gynecol Obstet 125:1239
Vohra VG (1967) Roentgen manifestations in Ewing's sarcoma. A study of 156 cases. Cancer 20:727
Wilner D (1982) Radiology of bone tumors and allied disorders. WB Saunders, Philadelphia, p 2516
Wilson JS, Korobkin M, Genant HK, Bovill EG (1978) Computed tomography of musculosekeletal disorders. AJR 131:55
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Levine, E., Levine, C. Ewing tumor of rib: Radiologic findings and computed tomography cotribution. Skeletal Radiol 9, 227–233 (1983). https://doi.org/10.1007/BF00354122
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DOI: https://doi.org/10.1007/BF00354122